How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,259 to $12,589Professionalmedian $631 · 10th to 90th $87 to $1,318
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,258.93 Median $4,570.88 Typical High $9,120.11 | Facility | None | $1,258.93 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,258.93 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $3,467.37 Median $3,548.13 Typical High $3,630.78 | Facility | None | $3,467.37 | $3,548.13 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,380.38 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $575.44 Typical High $831.76 | Professional | None | $85.11 | $575.44 | $831.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $12,302.69 Typical High $17,782.79 | Facility | None | $9,332.54 | $12,302.69 | $17,782.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,819.70 | Professional | None | $1,348.96 | $1,584.89 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $758.58 Median $1,513.56 Typical High $2,187.76 | Professional | None | $758.58 | $1,513.56 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,174.90 | $2,238.72 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $575.44 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $229.09 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $851.14 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $114.82 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $794.33 | $870.96 | $870.96 |
Where Utah sits
The same service costs 4.6 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AK $11,283KY $2,440
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.